I Never Would Have Guessed
by Starbase89
Summary: Life's struggles affect everyone differently. Some get past the bad, others need help and some force it out of sight.
1. Chapter 1

A/N: Hey everybody! This is my first attempt in a while to write. I had started two years ago but I never went beyond a chapter or two. This one will be different, and I may even get back to those. Wish me luck!

The team had been investigating incidents of unexplained behavior at the shipyard for the past week. It had been found that someone had been dosing sailors with PCP but they hadn't yet identified the culprit. They had been searching the office of one of the suspects, who as initially cooperating, but suddenly lashed out with a concealed box cutter. Agent McGee was caught off guard and was slashed across the arm and face. As he fell away, Gibbs and Tony tackled the sailor to the ground. Ziva called for help and within two minutes, Tim was loaded up and on his way to Bethesda.

Tim was foggy, but he listened to the chatter in the ambulance as they arrived at the hospital.

"Patient is male, mid-thirties. Pulse 110, BP 150 over palp. Involved in an altercation with an armed assailant. Injuries are an approx four inch laceration to the left cheek and twelve inch to the right arm. Bleeding is under control." came the voice of one of the EMTs.

"Thank you. Mr. McGee, I'm Doctor DiLaguardia. Are you in any pain other than from these cuts?"

"No, ma'am." He winced as he said it. Talking is not easy with the side of your face cut open.

"Can I give you something for the pain? Do you have any allergies to medication?" The doctor inquired

He wasn't one to complain about pain, but he could really feel the deep cuts.

"None that I know of, ma'am."

"Good. Nurse Carlyle! Take him to exam one. Give him 100 milligrams meperidine IM and start a saline IV."

"Yes Doctor."

Tim was wheeled to the small beige room where nurse Carlyle began taking vitals and cleaning him up. Once he was satisfied with the results, he drew up a syringe.

"Mr. McGee, this should take the edge off. Dr. DiLaguardia will give you a local when she comes in and stitches you up in a few minutes." He said as he stuck the needle into Tim's bicep.

Just as the pain medicine started to take effect, Gibbs walked into the room, also with a few small cuts on his face.

"Doing OK, Tim?"

The medication was starting to take effect and he was feeling a bit woozy, but he smiled and answered,

"I'm fine, boss!"

Gibbs smiled, knowing all too well why he seemed so content.

 _Yeah McGee, you're fine_ he said to himself

Gibbs turned to leave but stopped as he heard something crash behind him. When he did an about-face, he found Tim twitching and jerking randomly. He asked what was wrong, but got no response from his young agent. He ran out of the room and began yelling for help.

"Hey, I need a doctor in here NOW!"

Dr. DiLaguardia and two nurses came rushing in. Tim had progressed to a full blown seizure. His wounds, which had been stabilized, were oozing blood again. She didn't know what was happening, but was determined to find out.

"Four milligrams lorazepam IV, now."

Gibbs was in a panic, something that didn't often happen.

"What's going on? Tell me what's happening!"

DiLaguardia didn't answer; she was focused on her patient.

The nurse injected the drug into Tim's IV and the seizure began to subside, but he still didn't regain consciousness. The doctor began examining his vitals and found he had a temperature of one hundred six degrees. _This doesn't make sense._ she thought. _What could cause this?_

"I need cooling packs in here! Get them under his arms, legs and neck."

The nurses hurried to break the ice packs and get them to the vital points on the agent's body as the doctor tore open a bag of saline and poured it over his still body.

Gibbs was very visibly shaken and was shouting for answers, but not getting any. He noticed that the doctor had paused. He turned to her and asked

"Doc, what is going on? Why won't he respond!?"

The doctor looked up at him, coming up with thought and asked "Do you know if Mr. McGee is on any medication?


	2. Chapter 2

"What? No! There's nothing wrong with him!" Gibbs didn't understand this. McGee wasn't sick. He didn't see anything wrong. _He_ would have seen it.

"Are you absolutely certain, Agent Gibbs? This looks like a drug interaction, which based on the meperidine we gave him, could rapidly cost him his life."

 _What the hell do I do?_ He thought to himself. _If there is something wrong, I should know it._ He didn't want to ask the next question, fearing the answer.

"What is it?"

"It looks like neuroleptic malignant syndrome. We don't really know what the mechanism of it is, but it can happen when certain drugs," she paused, not knowing how much she should say, but she knew she had to. "... especially anti-depressants and anti-psychotics, are used in combination with drugs like the painkiller we gave him."

He couldn't believe what he was hearing. He knew his agents. Tim never seemed depressed, but he accepted it as a possibility. He knew he himself had certainly been there at times, but he never needed medication. But psychotic? _No! It can't be._

DiLaguardia saw that the senior agent was stuck in thought, but she needed information.

"Agent! Come back to me!"

Gibbs snapped out of his trance and looked up at her. While he still couldn't fathom what she had told him, he put aside his doubts and looked to her.

"I don't know. I don't know! If...if it is that, can you help him?"

"We'll keep him sedated and keep him cold until the fever comes down. We'll be giving him a drug called bromocriptine, which can sometimes reverse the reaction."

Gibbs didn't like that word _sometimes._

"So you're saying it might not work?"

"I'm afraid there is no magic bullet against this syndrome. Even with aggressive treatment, the mortality rate is between fifteen and twenty percent."

Gibbs had always known that there was the possibility of losing his people on the job. He hated thinking about it, but he acknowledged the chance. It came with working in law enforcement. But the idea of losing one of his team to a random medical occurrence was sickening.

"If that drug fails, we have a few others we can try."

"Doctor, do whatever you can to bring him back. I will not lose him like this!"

She nodded and starting going, fast. It had to be fast for the young agent to win this battle.

"Nurse Mitchell, push succinylcholine and etomidate." She grabbed a laryngoscope and prepared to intubate Tim. Within a minute, he was on the ventilator and headed up to the ICU.

Gibbs couldn't believe what he was seeing. His junior agent, who he thought of like a son, was completely helpless. Not only was there a tube down his throat breathing for him, there were all sorts of other of tubes and wires hooked up to his frail form. And then were the untouched deep cuts still on his face and arm. As Tim was rolling down the corridor, Gibbs felt completely helpless, something he rarely felt.


	3. Chapter 3

"Duck, I need you to get down to Bethesda now. McGee has some kind of drug interaction with the anesthetic they gave him."

"Oh Dear. Did they say the cause?"

He didn't want to get into that right now. The doctor had to be mistaken. If true, this kind of information could destroy McGee's career

"We'll talk when you get here, Duck." He hung up the phone. Then he dialed Tony

"Hey boss! How's McGee?"

"Not good. McGee has had...a complication."

"What does that mean? Is he okay?"

"I'll tell you more when you get here, Dinozzo."

"I'll be down there in twenty." Tony hung up.

Gibbs was just wandering around aimlessly for a while. How was he supposed to process what he now knew? After what seemed like hours, he saw Ducky turning into the corridor and felt some relief. He needed someone now to help him understand and there was no one better.

"Jethro. How is he?"

"They brought him to intensive care about a half hour ago."

"Dear Lord, what happened?"

"The doctor said something about," he stuck his hand in his coat pocket and pulled out the post-it note, "...neuroleptic malignant syndrome."

"That's not possible. Timothy isn't taking any medication that would cause that reaction." He paused and took a deep breath. "At least, there's nothing in his file."

 _Yeah, my thoughts exactly._ "Let me see if I can get any more information."

Gibbs approached the nurse's station.

"Agent Gibbs, NCIS. Can you tell me anything about my agent Timothy McGee?"

"One moment, sir." The man at the counter made a phone call up to the ICU. Gibbs couldn't see what he was saying. He couldn't stand being out of the loop.

"Agent Gibbs, we need to contact someone who can make medical decisions on Tim's behalf. Do you know who we should call?"

 _They're preparing for the worst,_ he thought. "I have his medical proxy. His mother is on the other side of the country and his father is dead."

The nurse realized that this man was McGee's family and replied, "All right, then. They want you in the ICU. Turn this corner, take the elevator to the fourth floor and turn left. He is in room 121."

Gibbs didn't say anything. He made haste for the elevator, not quite running but moving very quickly nonetheless. Ducky was following in a slower, though hurried pace. They were at the room in a minute, at most.

Tim looked much the same as he had when he last saw him. He was on a ventilator with two IVs and more wires than he could easily count. His cuts had been stitched up, but his face was holding in a pained expression. He noticed his hands and feet jerking intermittently.

Doctor DiLaguardia walked in reading the chart in her hands and bumped into Gibbs.

"Agent Gibbs, thank you for coming up. Donald Mallard?"

"Yes...Angela DiLaguardia! It has been too long. Can you tell us anything about our dear friend's condition?"

She hesitated. She wanted to reassure her old friend, but she didn't want to spread what she knew beyond those who had to know.

"Doc, I've got his proxy and Duck here may as well be Tim's doctor. You can tell us anything."

"All right Agent Gibbs, Donald; We have confirmed neuroleptic malignant syndrome, or NMS. We found clinically significant levels of fluoxetine, olanzapine and lithium in his blood. These, in combination with the shot of Demerol we gave him in the ER, likely precipitated the reaction."

Gibbs didn't know the significance of what she was saying, so he looked to Doctor Mallard to his left for clarification. Ducky's face was painted with both realization and disbelief.

"Jethro, fluoxetine is an antidepressant and…"He had to think before he could continue. He could only fathom the consequences of this coming to light. "Olanzapine and lithium and used to control the symptoms of bipolar disorder."

Just as the bombshell had been dropped, Tony and Abby came into the room.

"Hey Boss, How's...McGee? What the hell happened?"

"What's wrong with him, Gibbs?"

Gibbs just stared at his prone agent. He couldn't find words.


	4. Chapter 4

"Gibbs! What's wrong with Tim?" Abby was near tears. All she knew was that one of her best friends was unconscious with a machine breathing for him.

Tony just stood there, watching the rise and fall of McGee's chest and the occasional jerking movements in his limbs.

Gibbs wondered how much he should say. He didn't know anything for certain. Maybe there was a mixup at the lab. Maybe he had been dosed by someone looking to bring down his credibility. He decided to tell them _most_ of what he knew.

"McGee has apparently been taking some kind of medication that interacted with a painkiller they gave him when he was admitted. The doctor thinks she knows what caused it, and they are treating him."

Dinozzo jumped at the obvious omission, "What kind of medication? Tim's as healthy as you or I. This doesn't make sense."

Gibbs was looking at him, not sure what he should do, but then he looked to Abby. She wasn't asking questions. It looked as though she was considering something big, but she wasn't talking. There wasn't time for this kind of doubt.

"Abby. What do you know?"

"Gibbs, I promised Tim that I…"

"Abby, Tim may not make it unless we know exactly what we're dealing with."

She started to tear up. "I promised him, but I know I have to...A few years ago, I was at his apartment for a movie night and I saw a pill bottle."

"Lithium?" Ducky suggested

 _All right, they know more than they're telling me._ "Yes. When I asked Tim, he wouldn't say anything, other than to ask me to never mention it again. But I pushed and pushed. I went too far. He practically fell apart."

Gibbs was hearing things that would have surprised him an hour ago. McGee may have been a bit more sensitive than him or Tony, but he was strong. His confidence and self esteem had grown leaps and bounds since him shooting the cop eight years ago. He had come so far.

"He told you about his being bipolar?"

She hesitated again, "Yes."

Tony had stayed silent throughout the exchange, just trying to absorb all the information being forced onto him.

"Probie isn't manic depressive! Sure, he gets depressed, but we all do from time to time. And I've almost never seen him do anything impulsive. I'd see it. I've seen it."

"Anthony, what do you mean?" inquired Ducky.

"My cousin Deforest. We always thought he was just the life of the party, always so active and he seemed so happy."

"But?"

"He slit his wrists." He swallowed and took a deep breath. "He survived, but we all knew by then. He's been on medication for years and has been reasonably happy and healthy since."

"As Timothy has, apparently. That must be why we've never seen that side of him."

Before anything more was said, they heard a noise coming from McGee. He had opened his eyes and they were nervously scanning the room. Dr. Mallard left the room to find a doctor. Gibbs went to the bedside.

"Tim, you're okay. The doctor is on the way. Try to stay calm."

McGee seemed to be in full blown panic. He moved his uninjured are up to his face and tried to pull the breathing tube, but Gibbs held his arm.

"Stop, McGee! Calm down. I know you are scared, but we are in this together. You hear me?"

McGee nodded and began to settle down.


End file.
